Impact of low level magnification on incipient occlusal caries diagnosis and treatment decision making

Benefits of using magnification in dental specialties - a narrative review

An increased number of clinicians are using magnification to facilitate their vision when carrying out dental examinations and treatments. The best instrument for this purpose is the microscope, which has proven to enhance quality, longevity and outcome of clinical work. Its use in some dental specialties (such as endodontics) is now well established, but there is also a role for this equipment in other branches of dentistry. To anticipate the contribution of magnification to dentistry in general, recent research and experimental data on the importance of magnification devices will be considered, from the perspectives of optical issues, diagnosing methods and treatment options. It will be shown that, while the microscope is vital to certain specialties (such as endodontics, periodontics, restorative dentistry and prosthodontics), it has little effect on others (orthodontics, for example). This synthesis of current researchattempts to shed light on the optimal magnification used in certain clinical situations, the distinctive benefits of loupes and microscopes for each dental branch, as well as their drawbacks.

Magnification effect on fine motor skills of dental students

OBJECTIVES

This study observed the effect of different magnification systems on dental students' real and perceived fine motor skills.

METHODS

This was a laboratory-based experimental study. Students in the fifth year of an undergraduate dentistry program (N = 92) participated in this study. The dependent variables were real motor skills, perceived motor skills and time required to complete the fine motor skills test. The independent variable was the use of a magnification system under four conditions. For each condition, the Dental Manual Dexterity Assessment was performed, which consisted of inserting the #3195FF bur into targets positioned on a Styrofoam plate. The accuracy of each penetration of the targets was scored, using a point system with a maximum possible score of 246 points. Students' perceived fine motor skills were assessed using a visual analog scale (VAS) that ranged from zero for no skills to ten for maximum skills. A descriptive statistical analysis and the repeated measures ANOVA were performed (α = 0.05).

RESULTS

The Galilean and Keplerian loupes were found to positively affect students' real fine motor skills (p<0.01); however, perceived fine motor skills and time were significantly better (p<0.01) under the naked eye.

CONCLUSIONS

Dental students' real fine motor skills were better when Galilean and Keplerian loupes were used, but the perceived fine motor skills were not.

Optical magnification has no benefits on the detection of occlusal caries lesions in permanent molars using different visual scoring systems: An in vitro study

Background

Some studies have addressed the influence of optical magnification on the detection of caries lesions using a visual scoring system. However, there is a lack of research related to the use of the CAST and ADA-CCS visual scoring systems. In addition, the reliability and accuracy of ADA-CCS index in permanent teeth were not studied yet. So, the aim of this study was to evaluate, in vitro, the influence of different levels of optical magnification on the detection of occlusal caries lesions in permanent molars using three visual scoring systems.

Material and Methods

One occlusal site per tooth was analyzed in 120 extracted permanent molars. Two trained examiners inspected the teeth using ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment), and ADA-CCS (American Dental Association-Caries Classification System) visual criteria, twice with each scoring system, with a one-week interval between examinations. The study was conducted in three phases: (A) without optical magnification, (B) using a binocular lens (3.5× magnification), and (C) using an operating microscope (16× magnification). Then, the teeth were sectioned longitudinally through the center of the selected site and the section with the more severe lesion was histological evaluated considering the D1 (lesions in enamel and dentin) and D3 (dentin lesions) thresholds.

Results

Kappa values for intra- and inter-examiner reproducibility were good to excellent for all systems. At the D1 threshold, sensitivity, accuracy, and area under the ROC curve were high for ICDAS and CAST in all phases. However, this was not the case for the ADA-CCS in phase C (<0.05). At the D3 diagnostic threshold, there was no significant difference between the visual scoring systems during the study phases (>0.05).

Conclusions

The magnification does not improve the accuracy of the visual scoring systems in the detection of occlusal caries lesions in permanent molars. Key words:Dental caries, caries detection, permanent teeth, visual examination, magnification.